Study design: There are several conservative methods of painful spasticity treatment. However, conservative methods do not always provide long-term and complete antispastic e ects in cases of spinal cord injury with severe painful spasticity. Objectives: The aim of the present study was to analyse and compare the e ectiveness of myelotomy by Bischof II and Pourpre in patients with paraplegia and severe painful spasticity in the late period after spinal cord trauma. Setting: Spinal Care Unit, Meir General Hospital, Israel. Methods: Twenty patients had longitudinal T-myelotomy by the Bischof II technique and 20 longitudinal myelotomy en croix (Pourpre). The spasticity was determined by evaluated muscle tone and muscle spasm according to the Ashworth and spasm ± frequency scales. The pain was determined by McGill short questionnaire. The results were calculated by the Wilcoxon signed rank test, by Mann ± Whitney U-test and Students t-test. Clinical outcomes after myelotomy in-patients with chronic spinal cord injury and painful spasticity were evaluated after 6 months, 5 and 10 year follow-up period. Results: Pain was relieved in all cases. The best motor antispastic e ect was achieved after Pourpre myelotomy in 18 of the patients (90%) were evaluated after a follow-up of 6 months, 15 patients (75%) after 5 years, and 11 patients (64.7%) after 10 years. Following Bischof II myelotomy results were classi®ed as good: in 13 patients ± (65%) at 6 months; in nine patients (45%) at 5 years and in six patients ± (40%) at 10 years. Statistical analysis showed no reliable relationship between the level of Spinal cord lesion (T4-T10) and the type of operation. No instability occurred as a result of antispastic operation in any patient. Conclusion: A higher rate of bene®cial outcome was achieved after Pourpre myelotomy. We recommend this operation for patients with paraplegia and painful spasticity, who do not have hope of regaining voluntary motor function. However, transections of basic pathways of spasticity are not always su cient for complete antispastic e ects. Good results after the operation may deteriorate in time. Therefore further investigations into the mechanism of the spasticity syndrome in the spinal cord injured patient are required.

Introduction/Objectives: Th e central idea of our presentation is MCI -a conceptual and pathological entity defi ned by Petersen et al. in 1995 and still under debate, surrounded by a sustained attention mainly because it is a stage where suitable medical and nonmedical interventions could potentially be more successful by comparison with later stages in which the changes are more and more dramatic and less susceptible to be amended.Participants, Materials/Methods: Th e fi rst part of our paper attempts the actual issues of the debate upon MCI concept: its usefulness, defi nition, etiology, clinical appearance and evolution, heterogeneity of the assessment scores, scales and criteria of defi nition, conversion predictors, cohorts under study, research outcomes, treatment algorithms etc., as well as to its position in the aging and cognitive pathology matrices. As practical topics, the diff erential diagnosis, prediction, the epidemiologic and risk factors and the drug and non-drug, preventive and curative interventions are also called into discussion. A special attention is paid to the exceptional high complexity of biological and functional changes that determines the MCI heterogeneous appearance.Results: Th e outcomes of our epidemiological, risk factors and the rate of conversion to Alzheimer's Disease studies in a cohort of MCI patients, as part of the EADC's DESCRIPA Project, are also overviewed. Conclusions:Th e main conclusion is that the heterogeneities related to MCI could potentially be overcome by defi ning "clusters" of neuro-pathological, neuro-psychological and functional changes to be monitored in their dynamics, aside to the requirement of "personalized attempt" and ethical issues concerning MCI patients' evaluation and therapeutic intervention design. Introduction/Objectives: Disorders of consciousness is frequent in the acute stroke. Determine the severity of stroke and mortality in relation to the type of disturbance of consciousness in patients in the acute phase of stroke. OUTCOME OF PATIENTS WITH DISORDERS OF CONSCIOUSNESS IN ACUTE STROKEParticipants, Materials/Methods: We retrospectively analyzed 201 patients with acute stroke at the Department of Neurology, University Clinical Center Tuzla, in the period from July 1st to December 31st 2008. Th e stroke was confi rmed in all patients by computed tomography within 24 hours after hospitalization. Disorders of consciousness are divided into quantitative and qualitative. Assessment of disorders of consciousness is performed by Glasgow Coma Scale1 and and the Diagnostic and Statistical Manual of Mental Disorders -Fourth Edition2 after admission. Th e severity of stroke was determined by National Institutes of Health Stroke Scale3. Results: Fifty-four patients had disorders of consciousness in acute phase of stroke (26.9%). Patients with disorders of consciousness on admission (19.9 ± 9.5 vs. 7.9 ± 5.1, p < 0.001) and discharge (11.4 ± 10.5 vs. 4.3 ± 3.9, p = 0.003) had a more severe stroke than patients without disturbances of consciousness. Th...